Friday, November 15, 2013

Some additional thoughts on this past week

I share Bill's frustration, which is why I've been noodling two areas of concern regarding the current state of the train-wreck:

First: while all the oxygen in the room is currently being sucked up by the disastrous roll-out of Healthcare.gov and the world-class ineptitude of the administration vis the "keep your plan fix," I believe that the real nightmare is still under the radar.

Last night, I had the privilege of sharing a meal with three very accomplished, very experienced IT infrastructure nerds experts. As one might expect , the talk eventually turned to the HC.gov debacle. I opined that "we ain't seen nuthin' yet;" that the real problem is that, once the site is "functional," the data hub which drives it must then deal with this challenge: reaching out to, communicating with, and accessing data from DHS, HHS, Social Security, the IRS and other agencies which will presumably confirm that the applicant is a citizen, eligible for a subsidy, etc.

None of these agencies have the same computer or operating systems, nor is their data likely to be compatible. Unlike Mr Spock's Federation, there's no Universal Translator to help them put this all together. So, even if they're able to get the front-end "fixed" (any takers on that bet?), don't count on this ship sailing.

Second: All this talk of the President "summoning" health insurance executives to the Oval Office for a pow-wow (after his ill-advised and clumsy attempt at a "fix" for his broken promise) is a waste of time, both his and the execs'.

Here's why: throughout this entire process, no one in a position of authority, either in drafting the ObamaTax itself, nor its myriad of additional regulations, has ever reached out to the folks who have actual working knowledge of the existing (but soon to be extinct) system.

That would be insurance agents.

But Henry, you may object, they've had plenty of meetings with, and input from, insurance company presidents. What more do you want?

Yes, well: asking a company exec about how insurance actually works is of zero value.

Hunh?

It's simple, really: the President of (for example) Aetna this week was president of Coke last week, and president of Sony the week before that. That is, he (or she) has great knowledge of business principles, but no practical knowledge of insurance. This is not in any way to denigrate the executives; I'm sure they're wonderful employers with great experience and ideas who call their mothers every week. But they do not (for the most part) have experience in the industry itself, nor have they (again, for the most part) ever sat down with a client at their kitchen table or at the office with a proposal and a pen. I would love to be wrong about this, but I've seen no evidence to the contrary.

Again, you're missing the point: AHIPis the insurance companies, not folks with one-on-one experience. And the associations are run by, and for the benefit of, the carriers. You don't think dues pay the freight, do you? At the local, or perhaps even the state level, these organizations do a yeoman's job because they at least pay lip service to the agent's value. At the national level - which is the only one that counts in this disaster - their interests (and by extension, the interests of their clients) are of no value or import.

And that's why you see Congresscritters and the President flailing about demanding that the carriers fix the mess that the government made: they never asked the people who could have given them workable answers.